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ENT · Audiology: Weber in sensorineural loss
Sample itemA man has reduced hearing in his left ear. The Rinne test is positive in both ears and the Weber test is heard louder in the right ear. What is the most likely diagnosis?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Left sensorineural hearing loss
With sensorineural loss the cochlea or nerve on the affected side perceives bone-conducted sound poorly, so the Weber goes to the better ear. Rinne stays positive because air conduction is still better than bone conduction. So the left ear is the affected one.
Option by option
A. Right conductive hearing loss
A right conductive loss would give a negative Rinne on the right.
B. Right sensorineural hearing loss
The Weber would then lateralise to the left ear.
C. Left sensorineural hearing loss (correct)
Correct. Positive Rinne with Weber lateralising to the better (right) ear points to left sensorineural loss.
D. Left conductive hearing loss
A conductive loss would give a negative Rinne on the left and Weber toward the left.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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